The Black Church and CVD: Are We Our Brother's Keeper? seeks to investigate the, as yet unaccounted for, burden of CVD outcomes for rural African American men in Orange County, NC by: (1) documenting the cultural tools of 26 rural Black churches' sacred role and their associations with the secular role of providing service to benefit men; (2) identifying and describing interruptions or deviations from the standard course of CVD screening and care, and perceived reasons from the points of view of men; and (3) comparing men's adherence to CVD care between an intervention and comparison church, before and after piloting a church- based Navigator protocol, which builds on elements of the church's sacred and secular roles, in partnership with a health department nurse. The study involves three phases, which are described in the following specific aims. Aim 1: To characterize current cultural tools of scripture, song, prayer and sermon within 26 rural Black churches of Orange County, NC by clergy demographics, Sunday congregation attendance, financial health, and type of community service events through a telephone survey with key members of the church clergy. Aim 2: To identify the meanings and impetus for change transferred to African American men by current cultural tools within rural Black churches about seeking and providing assistance for cardiovascular health through ethnographic participant observation in three representative churches and critical incident technique interviews with 45 African American men, who either have been diagnosed with CVD or have a close friend or relative with CVD. Aim 3: To pilot a 10-month intervention within one Black church congregation, in partnership with the chronic disease nurse of Orange County Health Department. Six men will be trained as Navigators to: screen 30 men in their congregation at risk for CVD and refer men diagnosed with CVD to health resources; provide them with physical activity and nutrition education; and monitor their adherence to their prescribed CVD care plan. The primary outcome for the pilot church will be proportion of men adhering to their CVD care plans. The secondary outcomes will be compared to those of a comparison church and measured at the individual and church levels. The research questions and study design were developed by our NC Community-Based Public Health Consortium, a 15-year community-based participatory research (CBPR) partnership of United Voices of Efland-Cheeks, Inc., Orange County Health Department, and the UNC School of Public Health and Center for Health Promotion and Disease Prevention. [unreadable] [unreadable] [unreadable]